NHS England: Waiting Lists

Lord Clark of Windermere Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

In our conversations with the NHS, we are talking about the workforce plan. We are looking at ways to improve the way in which the NHS and social care plan for their workforce. We have committed to continuing to reflect very carefully on points made by noble Lords across the House. honourable Members in the House of Commons and many stakeholders. It is important that we value the workforce of doctors, nurses and other healthcare workers whom people often forget about. We should also value all those other workers who have provided services to us during lockdown, such as delivery drivers, postal workers, Amazon workers et cetera. They have all played a vital role, and we should not forget the role of civil society organisations.

[Lord Clark of Windermere (Lab)]

My Lords, we all recognise that the NHS and care staff are working under intense pressure. To attract additional members is vital. With that in mind, will the Government be more welcoming to individuals from overseas by easing further their entry conditions for those willing to come and work in the NHS and care sector, including a reasonable period of time for them to remain here?

[Lord Kamall (Con)]

Immigrants have always played a vital role in our country. If we cast our minds back to the post-war period, there were massive shortages in healthcare but also other public services. Indeed, my own father came over to work on the railways and buses. It shows the importance of immigration and immigrants to this country from across the world.

NHS: Nursing Workforce

Lord Clark of Windermere Excerpts

Wednesday 8th September 2021 Lords Chamber

Asked by

[Lord Clark of Windermere]

To ask Her Majesty’s Government what plans they have to retain the nursing workforce in the National Health Service following their experiences during the COVID-19 pandemic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, we owe a huge debt of gratitude to the nurses in all parts of our healthcare system, who have done an amazing job through the pandemic. We are on track to deliver our manifesto commitment to have 50,000 more nurses by the end of the Parliament. This includes a focus on retaining nurses already working in the NHS and social care. We are taking action through the NHS People Plan to improve nurse retention by prioritising health and well-being, supporting flexible working and improving NHS workplace culture. The signs are that these efforts are paying off.

[Lord Clark of Windermere (Lab)]

My Lords, the training of these new, welcome recruits to the nursing profession will take some time. Immediate improvements will depend on the current staff, who feel battered and bruised following the intense pressure of Covid. Daily, nurses end up in tears at work and many are contemplating leaving. What specific plans—I stress “specific”—do the Government have to retain nurses to meet today’s growing problems in the NHS?

[Lord Bethell (Con)]

My Lords, I completely acknowledge the phenomenon of burnout that the noble Lord rightly points out; the NHS people recovery taskforce, appointed to tackle exactly that problem, is very much focused on it. It works in conjunction with the NHS retention scheme and has led to the appointment of new well-being guardians, which have made a huge impact. The statistics suggest that the leaving ratio, previously at 10.3%, has now been reduced to 8.3%. That is an encouraging sign, but we have a number of other measures in place to ensure that retention remains upward at a time when, as he pointed out, nurses are under huge pressure.

Covid-19 Update

Lord Clark of Windermere Excerpts

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

The right reverend Prelate puts it extremely well. I pay tribute to all the community groups which have an influence on the thinking of the nation. I encourage them to use that influence to engender and support a spirit of community consideration so that we can try to come together as a nation and approach public health in a way that is considerate to each other.

On the specific point of singing, as I took my place, I noticed that the Secretary of State for the Department of Digital, Culture, Media and Sport was in the process of making a Statement, and I refer the right reverend Prelate to that. I am afraid I have not had a chance to read it.

[Lord Clark of Windermere (Lab)]

My Lords, as the Government have already admitted, one result of their new controversial policy will be an extra 100,000 cases a day of Covid-19, possibly within the next month, which will lead to further heavy demands on an overpressed NHS. How do the Government intend to retain the already overworked and burned-out health workforce going into this battle on an offer of £1 a week pay rise after all the effort they have put in?

[Lord Bethell (Con)]

My Lords, I pay tribute to the NHS, but the rise in infections among mainly very young people will not necessarily lead immediately to a large increase in the demands on the NHS. An extraordinary aspect of this disease is that it targets the elderly and those with comorbidities and leaves the young largely alone. The proportion of people who have the disease in the months to come will mainly be the unvaccinated. Those are mainly the young and our modelling, which is supported by the NHS, suggests that our resources in healthcare can support that kind of situation.

Covid-19 Update

Lord Clark of Windermere Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I agree with the noble Baroness that many are curious about whether they have antibodies, but I warn her that the presence of antibodies does not necessarily correlate with immunity. Some people have strong immunity and no antibodies, and some have antibodies but not immunity. This is one of the mysteries of the body’s response to the disease and one of the reasons why it has been such a confounding disease to fight. But if anyone does want an antibody test, they should ask their GP and it can be arranged.

[Lord Clark of Windermere (Lab) [V]]

My Lords, very bluntly, we are facing this unpalatable Statement today because of the Prime Minister’s inability to take decisions. The Government learned of the arrival of the Indian variant as early as 25 March, yet took no action for 30 days, allowing 20,000 people to enter the UK. The result is that they put the public’s health at risk. As a consequence, we now face a further four weeks of restrictions, with accompanying hardships. Have the Government learned their lesson?

[Lord Bethell (Con)]

My Lords, I am not sure whether I accept the characterisation presented by the noble Lord. We have worked incredibly hard to bring in a managed quarantine system that is a novel, new introduction into the UK. We have done extremely well in fighting off many of the variants that have come to our shores, including the Manaus variant, the South African variant and others. We have strong links with Pakistan, India and Bangladesh, which means there is a lot of traffic between our countries. I am not sure whether it would ever have been possible to prevent this variant making landfall in the UK at some point. But we have done an enormous amount in the UK to delay and prevent the arrival of these variants, and for that I am enormously grateful to those involved.

NHS: Staff Numbers after Covid-19

Lord Clark of Windermere Excerpts

Thursday 4th March 2021 Grand Committee

Asked by

[Lord Clark of Windermere]

To ask Her Majesty’s Government what plans they have for the number of National Health Service staff after the COVID-19 pandemic.

[The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)]

The time limit for this debate is one hour.

[Lord Clark of Windermere (Lab) [V]]

My Lords, I count myself very fortunate to be introducing this Question. This is an invaluable parliamentary means whereby questions can be asked in a more discursive manner than usual and the Minister will listen and, we hope, provide answers. I shall make a couple of obvious general points.

The people of Britain love the NHS, as has been seen during the Covid-19 pandemic, but there were problems prior to the pandemic. I shall make three basic points to set the scene. The NHS is the fifth-largest employer in the world, yet we spend less on health as a percentage of our GDP than almost every other developed country in the world. To compound the situation domestically, there was a shortage of hospital beds prior to the pandemic. Indeed, we are bottom of the Euro league for intensive care beds, with 7.3 beds per 100,000 of population, compared with the best, Germany, with 33.8 beds—what a difference. Thus, prior to the previous cuts we were ill-prepared, and there have been too many cuts under the austerity measures of the early 21st century.

I am certain in my own mind that it was due only to the dedication, brilliance and sacrifice of NHS staff that we got through—and I mean all staff, from the top consultant to the most junior worker. And it has been at tremendous cost to many of them in stress, burnout and mental health challenges. We owe them a tremendous amount and I hope that, in his summing up, the Minister will confirm that this will be recognised when we have won the battle with Covid-19.

I will begin with nurses. Over the years, the Minister must have become tired of me pursuing him on the issue of nurses. I remain concerned. Currently, we are at least 40,000 nurses short. Over the next seven years we will face a shortfall of 108,000 nurses. I must ask the Minister very bluntly: will HMG drastically increase the training of fully qualified nurses? What discussions has he had to ensure the provision of the educational means to do so?

The Royal College of Nursing has conducted surveys and expressed deep concern about the exodus of qualified staff following the pandemic. I share that concern. Will the Minister push ahead and prepare plans to deliver what is necessary to persuade staff that they are valued, and to retain them in the NHS? According to the RCN survey, 35% of nurses are contemplating leaving the profession within the year. Will HMG also provide the NHS with the means to fund occupational health and psychological support, and, if necessary, breaks beyond annual leave?

Nurses are due a pay rise. They are currently worse off than they were a decade ago. Will HMG ensure that the upcoming pay settlement is really meaningful and commensurate with the ever-rising skills of nurses?

I turn now to GPs. If we are to meet the demands and expectations of the general public, we will have to increase the number of doctors, especially GPs. Does the Minister accept that we are still suffering in the training of doctors from the austerity years, over which his party presided? In spite of the modest increases of late to close the gap, does he accept that we face a shortfall of 7,000 GPs in the next two years? As a starter, we need to double the number of medical school places from 7,500 to 15,000 by the end of the decade.

I will move on from numbers to talk about processes. I am concerned about the reluctance of younger practitioners to enter general practice in many parts of the country, leaving it often to only elderly GPs to carry on as single practitioners, supplemented by agencies and bank locums. Do the Government really feel that that is satisfactory and sustainable?

I have a personal problem with this in Windermere at the surgery I am registered with. It operates from a fine purpose-built building but has been without a permanent GP for a number of years. It functions largely due to the skill, experience, training and commitment of nurse practitioners and other staff with specialist skills. Their work is supplemented by local doctors—if they can be persuaded to come. Five years ago, the practice was leased to a private company, OneMedical Group, 80 miles away in Leeds. Last autumn it took advantage of a break clause in its lease and surrendered it, and we are back to square one; it is far from a satisfactory situation.

The key issue is that younger GPs do not wish to buy into practices which might involve hundreds of thousands of pounds. I know a number of practices in Cumbria have had to undertake severe reorganisation and mergers simply to survive. In a letter to the Guardian on 1 March, a GP who has worked in the NHS for over 30 years made the same point, that younger GPs will not buy in to practices. I ask the Minister the most critical question that I am asking today: is this model, requiring such large financial commitments by individuals, suitable to the 21st century? Would the department do a preliminary examination of this problem?

The pandemic has changed so much, and we were found wanting. The years of austerity caused serious damage to our NHS. Only because of the beliefs of our NHS staff are we getting through it. One thing is clear: there is increased demand on our health service. There will have to be much change, including permanently increasing spending. The Government will have to recognise that what may have worked in the past may not do so in future. Models which have been sacrosanct may need to be examined and, if necessary, changed. All this is essential, with a radical White Paper bringing health and social care together. I ask the Minister: are the Government up to it?

Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021

Lord Clark of Windermere Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Clark of Windermere (Lab) [V]]

My Lords, I thank the Minister yet again for introducing an SI in a clear manner, which provides much certainty to the police. That is what is needed, and I thank the Minister for it.

This SI is complicated, detailed and technical. The Minister is right, and the Government are right, to try to ensure that it is perfect, but, like many complicated SIs, it depends on basic information. If this information proves to be incorrect or false, no matter how complicated the SI is, it will not work. I will give an example of that by citing an incident which has become public today. We have learned that a number of people have entered Britain from Brazil carrying the dangerous P1 variant. They have managed to trace six of the individuals but cannot trace the seventh because the person who filled the forms in did so incorrectly and provided no contact details. This makes my basic point: if the information provided is incorrect—and it was a standard form—and the form is not checked by any official, we have only that incorrect information. As it was incorrect, we have had someone entering from Brazil carrying a very dangerous disease. We do not know where that person is. Will the Minister try to ensure—I know that it is not easy—that the Border Force has sufficient individuals at the border to check every single form?

Food-related Crime

Lord Clark of Windermere Excerpts

Monday 22nd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I bow to the noble Baroness’s great expertise on the correlation between poverty and crime. But that makes no excuse for the kind of crimes we are talking about here. Many are either brutal—as the noble Baroness, Lady Jones, referred to—or crimes of fraud, for which there is no excuse.

[Lord Clark of Windermere (Lab) [V]]

My Lords, I am encouraged by the Minister’s response today, and I am sure that many Members of the House will wish him well in persuading his colleagues to give more power to the NFCU. As he does so, will he ensure that the new system is integrated completely with the more established direct farm-related food regulations and crimes?

[Lord Bethell (Con)]

My Lords, the NFCU has done an enormous amount in working with stakeholders. Although it is a relatively small unit, with just 80 individuals, it works extremely closely with trading standards officers in local authorities and with policing authorities up and down the country. It leverages its expertise, and we hope to be able to augment that expertise with investigatory powers so that it can relieve police forces from some of the application of justice in this area.

Covid-19: Self-Isolation

Lord Clark of Windermere Excerpts

Wednesday 10th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the surveys are not crystal clear about practice, but on the whole the UCL survey and our own interrogation of those isolating suggest that compliance is much higher than the noble Lord implies. I pay tribute to local councils, which are doing an enormous amount to provide the kind of economic support that the noble Lord quite rightly alludes to. Blackburn with Darwen, for instance, provides an enormous amount of support for those with annual earnings under £21,152. In Colchester, applicants must not have more than £16,000 in capital, but the council provides a substantial discretionary payment. It is this kind of targeted local support that we believe can make an enormous difference.

[Lord Clark of Windermere (Lab) [V]]

My Lords, Yvette Cooper, the chair of the Commons Select Committee on Home Affairs, has reiterated that there is no testing at airports, with incoming passengers able to leave the terminal and go directly to public transport. This has been reinforced on television with passengers leaving Heathrow without any checks whatever, having flown in from South Africa via Dubai. Does the Minister believe that such slackness keeps the British people safe?

[Lord Bethell (Con)]

My Lords, I do not accept the accusation of slackness. Testing should happen before the flight, not at the airport. All those who seek to avoid the red list protocols will be interviewed by the police, and the kinds of fines ascribed to that offence have been made crystal clear in the Statement by my right honourable friend the Secretary of State for Health.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021

Lord Clark of Windermere Excerpts

Monday 8th February 2021 Grand Committee

[Lord Clark of Windermere (Lab) [V]]

My Lords, I thank the Minister for all the work he has done in fighting this terrible pandemic. I wish him well with all his efforts in future, but perhaps I can be a little critical of details today, because underpinning this SI are the basic nuts and bolts which make the system work—and they are creaking in places.

We sometimes do not realise that there is a difference between guidelines, which are what Ministers would like us to do but do not have the force of law, and regulations, which do have that force. As we have gone through the tiers created by the Government over the past year, some of the issues have been about guidelines and some about regulations. Let me give a couple of simple examples.

Colleagues will recollect that at the beginning of the year, two women were handed fixed penalty notices by Derbyshire police for reportedly travelling five miles for exercise. The police force subsequently stated that it was reviewing the action based on new national guidelines, but the issuance of the notice was still supported by the Health Secretary, although it did not have the force of law. Then of course we had a similar case—I am not making this as a political point—when the Prime Minister was cycling 18 kilometres to ride around a park in London. I have no trouble at all with that, but the issue is that it causes problems on a wider scale, and with tragic results.

I live in a national park. As I look out of the window, the snow is falling—the hills are covered in snow. Although people have guidelines that the Government’s wish is that they should not drive to the Lake District, but they do. Every weekend, they are still driving regularly from Manchester, Newcastle, Liverpool, Kent and London. That is not illegal, but they are not allowed to spend the night. How do you trap people who are sometimes spending the night?

We had a tragic incident this last weekend involving the mountain rescue, which has been called out several times, when two young men went camping on the mountains above Kirkstone Pass. One of them got chest pains and called the mountain rescue in the middle of the night—it was two in the morning. One member of the mountain rescue slipped and fell; he has very serious injuries.

However, the police cannot stop people driving in to camp. Once they have camped, they can be issued with penalty notices because that is in a regulation: you cannot stay overnight in an area such as this. I am arguing that there needs to be some consistency in the regulations and guidelines so that we know where we stand, and that the police also know what they can and cannot do.

[Lord Naseby (Con) [V]]

I just pushed on the button that said unmute—

Hotel Quarantine for Travellers

Lord Clark of Windermere Excerpts

Wednesday 3rd February 2021 Lords Chamber

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

The next speaker is the noble Baroness, Lady Masham of Ilton. Is the noble Baroness with us? We will come back to the noble Baroness. Let us go to the noble Lord, Lord Clark of Windermere.

[Lord Clark of Windermere (Lab) [V]]

My Lords, the Minister said that he believed there was a basic right to travel. I put it to him that there is an even greater right to live, yet we have the highest death rate per head of the population of any country in the world. Should we not put the right to live at the top of our agenda?

[Lord Bethell (Con)]

I could not agree with the noble Lord more: the right to live trumps all other rights. It is a sad fact that, while we would normally do everything we could in a liberal democracy to protect rights such as the freedom to travel, under current circumstances these are trumped by the right to live, and that is why I call on all people to limit their travel wherever they humanly can. There is simply no excuse for going to Dubai, taking Instagram photographs of yourself and claiming that that is business travel. You are putting your friends and loved ones at risk, and this Government will not tolerate it.